Seronegative autoimmune limbic encephalitis is a rare clinical syndrome defined by a rapid onset of cognitive impairment with neuropsychiatric features and an absence of associated autoantibodies that often lead to diagnostic uncertainty, delayed treatment and ultimately, poor prognosis. Here a case is presented that highlights the benefits of implementing a multidisciplinary approach to treating the psychiatric manifestations, including a cautious use of therapeutic home leave for patients where the clinical course is prolonged.